The primary aim of this study is to investigate the effects of a relaxation-guided imagery (R-GI) audiotape intervention on maternal perceived stress, anxiety, and corticotropin releasing hormone (CRH) level prior to the third trimester in African American women. Preterm birth (PTB) and low birth weight (LBW) are the leading cause of perinatal morbidity and mortality. Despite advances in health care, PTB and LBW rates are increasing. Investigators believe PTB is not an acute event but rather the end point of chronic pathophysiologic changes that occur before clinical symptoms appear. Research suggests that prenatal maternal stress (PNMS), defined as perceived stress and anxiety, in women of different racial and ethnic backgrounds is an important and independent risk factor for PTB. PNMS may initiate disturbances of body processes that result in a cascade of biochemical events with potential pathways to PTB. Central to these pathways is CRH, one of the major, ethnic-specific regulators of the biochemical response to PNMS. Relaxation and guided imagery (R-GI) are regarded as potent, cost-effective health care modalities that may bring about significant physiologic and biochemical changes, although no studies to date have investigated the effects of R-GI intervention on PNMS or CRH in pregnant women prior to the third trimester while controlling for ethnicity. Demonstrating the effectiveness of R-GI audiotapes to reduce PNMS and CRH in African American women is the first step in evaluating whether or not this intervention may be effective in reducing PTB in future studies with larger samples of ethnically diverse women. [unreadable] [unreadable]